CHS47 Monitor and assess patients following treatments

Overview

This standard is about monitoring and assessing patients during and following treatments.  It concerns the surveillance of patients who have completed treatment, as well as checking for any complications.  Treatments may involve, for example, surgery, chemotherapy, radiotherapy and medical therapy. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 1

Knowledge and Understanding

You will need to know and understand:

1. Methods of obtaining valid consent and how to confirm that sufficient information has been provided on which to base this judgement
2. The treatments used in your area of practice and their early and late effects and complications
3. The use of a structured approach to the assessment of patients
4. How to assess potentially complex conditions in the context of co-morbidity and other factors such as medications
5. The signs and symptoms of recurrent disease and post-treatment complications
6. Short, medium and long term effects of disease on patients physical, psychological and biological states and those of the families
7. The further investigations that may be required
8. Where the further investigations can be carried out, who undertakes them, how to request them and the timescales involved
9. Normal and abnormal results from further investigations and their implications
10. Genetics and the significance and implications of family history
11. How to interpret evidence from clinical examination, history taking and further investigations in order to make an assessment
12. How drugs and medication can affect conditions
13. How the patients current medication may affect their condition
14. The anatomy and physiology of the human body
15. The organs of the human body and their functions
16. How the organs interact with each other
17. How to adapt communication styles in ways which are appropriate to different people (e.g. culture, language or specific needs)
18. How to establish an understanding of patients values, beliefs and interests
19. How to ask questions, listen carefully and summarise feedback
20. Methods of communicating stressful information to patients
21. The importance of providing patients with opportunities to ask questions and increase their understanding
22. The importance of minimising any unnecessary discomfort, and how to do so
23. The range of diverse cultures prevalent in the community
24. The effects of different cultures and religions on care management
25. The importance of respecting patients privacy, dignity, wishes and beliefs and how to do so

Performance Criteria

You must be able to do the following:

1. check the patient’s identification details and confirm you have the right notes before commencing the assessment
2. consider the psychological condition of the patient and take this into account during the assessment process
3. ask the patient to explain any new symptoms following treatment
4. respect the patient’s privacy, dignity, wishes and beliefs
5. establish the patient’s ability to understand the consultation with the help of a carer or interpreter if necessary
6. explain the assessment process and obtain the necessary agreement and consent
7. ask appropriate targeted questions relating to the patient’s history and any presenting symptoms to assess the likelihood of recurrent disease or the presence of post-treatment complications
8. minimise any unnecessary discomfort and encourage the patient’s full participation in the assessment
9. carry out and interpret a systematic clinical examination
10. request further investigations, if indicated, following national, local and organisational guidelines and protocols
11. consider all the relevant evidence from the patient’s history and clinical examination and make a justifiable assessment
12. ascertain whether the patient has understood the outcome of the assessment and is satisfied with the process
13. discuss the assessment outcome with the patient to enable them to think through the implications and how these can be managed
14. make a full, accurate and clear record of the information obtained, the topics discussed with the patient and the assessment outcome

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: HWB6 Assessment and treatment planning This standard has replaced HCS_NIR6